Background and Objectives: Electrocardiographic (ECG) markers of the temporal dispersion of the myocardial repolarization phase have been shown able to identify chronic heart failure (CHF) patients at high mortality risk. The present prospective single-center study sought to investigate in a well-characterized cohort of decompensated heart failure (HF) patients the ability of short-term myocardial temporal dispersion ECG variables in predicting the 30-day mortality, as well as their relationship with N-terminal Pro Brain Natriuretic Peptide (NT-proBNP) plasmatic values. Method:One hundred and thirteen subjects (male: 59, 67.8%) with decompensated CHF underwent 5 min of ECG recording, via a mobile phone. We obtained QT end (QTe), QT peak (QTp) and T peak to T end (Te) and calculated the mean, standard deviation (SD), and normalized index (VN). Results: Death occurred for 27 subjects (24%) within 30 days after admission. Most of the repolarization indexes (QTe mean (p < 0.05), QTeSD (p < 0.01), QTpSD (p < 0.05), mean Te (p < 0.05), TeSD (p < 0.001) QTeVN (p < 0.05) and TeVN (p < 0.01)) were significantly higher in those CHF patients with the highest NT proBNP (>75th percentile). In all the ECG data, only TeSD was significantly and positively related to the NT-proBNP levels (r: 0.471; p < 0.001). In the receiver operating characteristic (ROC)analysis, the highest accuracy for 30-day mortality was found for QTeSD (area under curve, AUC: 0.705, p < 0.01) and mean Te (AUC: 0.680, p < 0.01), whereas for the NT-proBNP values higher thanthe 75th percentile, the highest accuracy was found for TeSD (AUC: 0.736, p < 0.001) and QTeSD (AUC: 0.696, p < 0.01). Conclusion: Both mean Te and TeSD could be considered as reliable markers of worsening HF and of 30-day mortality. Although larger and possibly interventional studies are needed to confirm our preliminary finding, these non-invasive and transmissible ECG parameters could be helpful in the remote monitoring of advanced HF patients and, possibly, in their clinical management. (ClinicalTrials.gov number, NCT04127162).

Short-period temporal dispersion repolarization markers predict 30-days mortality in decompensated heart failure / Piccirillo, Gianfranco; Moscucci, Federica; Bertani, Gaetano; Lospinuso, Ilaria; Mastropietri, Fabiola; Fabietti, Marcella; Sabatino, Teresa; Zaccagnini, Giulia; Crapanzano, Davide; Di Diego, Ilaria; Corrao, Andrea; Rossi, Pietro; Magrì, Damiano. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 9:6(2020). [10.3390/jcm9061879]

Short-period temporal dispersion repolarization markers predict 30-days mortality in decompensated heart failure

Piccirillo, Gianfranco
;
Moscucci, Federica
;
Bertani, Gaetano
;
Lospinuso, Ilaria
;
Mastropietri, Fabiola
;
Fabietti, Marcella
;
Sabatino, Teresa
;
Zaccagnini, Giulia
;
Crapanzano, Davide
;
Di Diego, Ilaria
;
Corrao, Andrea
;
Magrì, Damiano
2020

Abstract

Background and Objectives: Electrocardiographic (ECG) markers of the temporal dispersion of the myocardial repolarization phase have been shown able to identify chronic heart failure (CHF) patients at high mortality risk. The present prospective single-center study sought to investigate in a well-characterized cohort of decompensated heart failure (HF) patients the ability of short-term myocardial temporal dispersion ECG variables in predicting the 30-day mortality, as well as their relationship with N-terminal Pro Brain Natriuretic Peptide (NT-proBNP) plasmatic values. Method:One hundred and thirteen subjects (male: 59, 67.8%) with decompensated CHF underwent 5 min of ECG recording, via a mobile phone. We obtained QT end (QTe), QT peak (QTp) and T peak to T end (Te) and calculated the mean, standard deviation (SD), and normalized index (VN). Results: Death occurred for 27 subjects (24%) within 30 days after admission. Most of the repolarization indexes (QTe mean (p < 0.05), QTeSD (p < 0.01), QTpSD (p < 0.05), mean Te (p < 0.05), TeSD (p < 0.001) QTeVN (p < 0.05) and TeVN (p < 0.01)) were significantly higher in those CHF patients with the highest NT proBNP (>75th percentile). In all the ECG data, only TeSD was significantly and positively related to the NT-proBNP levels (r: 0.471; p < 0.001). In the receiver operating characteristic (ROC)analysis, the highest accuracy for 30-day mortality was found for QTeSD (area under curve, AUC: 0.705, p < 0.01) and mean Te (AUC: 0.680, p < 0.01), whereas for the NT-proBNP values higher thanthe 75th percentile, the highest accuracy was found for TeSD (AUC: 0.736, p < 0.001) and QTeSD (AUC: 0.696, p < 0.01). Conclusion: Both mean Te and TeSD could be considered as reliable markers of worsening HF and of 30-day mortality. Although larger and possibly interventional studies are needed to confirm our preliminary finding, these non-invasive and transmissible ECG parameters could be helpful in the remote monitoring of advanced HF patients and, possibly, in their clinical management. (ClinicalTrials.gov number, NCT04127162).
2020
QT; QTVI, QT variability index; T peak–T end; chronic heart failure; mortality; temporal dispersion of repolarization phase.
01 Pubblicazione su rivista::01a Articolo in rivista
Short-period temporal dispersion repolarization markers predict 30-days mortality in decompensated heart failure / Piccirillo, Gianfranco; Moscucci, Federica; Bertani, Gaetano; Lospinuso, Ilaria; Mastropietri, Fabiola; Fabietti, Marcella; Sabatino, Teresa; Zaccagnini, Giulia; Crapanzano, Davide; Di Diego, Ilaria; Corrao, Andrea; Rossi, Pietro; Magrì, Damiano. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 9:6(2020). [10.3390/jcm9061879]
File allegati a questo prodotto
File Dimensione Formato  
Piccirillo_Short-Period_2020.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 1.74 MB
Formato Adobe PDF
1.74 MB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1421581
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 10
  • ???jsp.display-item.citation.isi??? 9
social impact